brca-2 advanced prostate cancer. Anyone with experience of parp inhibitors and expertise on how this affects prognosis.

[Nowhereman9]

just found out my cancer is brca2

[Tall_Allen]

If you are castration-resistant, the latest evidence is to take a PARP inhibitor with an advanced hormonal:

prostatecancer.news/2022/06...

[mrscruffy]

I too am positive BRCA2, haven't needed a Parp inhibitor yet but sure i will in the future. Been on ADT successfully for 7 years 2 months

[MyDad76]

You might check posts from HopingForTheBest1. I remembered he was using parp inhibitor.

[Cooolone]

How does any Oncologist provide prognosis for any given therapy? Roll the dice! Previous performance does not always predict future results. Everyone is different!

The question is the use of therapy lines and their timing, efficacy and exhaustion. PARP Inhibitors have been shown to have great effect, but is it something needed, and when? Used once we become resistant? Or straight up out of the gate for an advanced patient? Or only after other therapy lines fail? In conjunction with and concurrent with other therapies... These are the questions!

It's all interesting of course and highly individual!

I was on Relugolix and it failed or was failing... Swithed to Degarelix and had a response, added Olaparib and response was even better AND then Lynparza a few months later. Have been stable for a while now, was interesting because the Relugolix seemed to not be working, but the injection did. Olaparib knocked the PSA back down to undetectable levels on its own, and the Lynparza was added as a kicker! Yes, I'm BRCA 1 & 2 deleted... So it's interesting to say the least.

Another facet of our dilemma is the metabolic side of things which goes largely ignored by modern oncology teams. Anyways, that's for another thread, lol.

Now the question is, of course, how long does it, or will it work? Lol. Would adaptive therapy possibly extend it's effectiveness? Would I have the fortitude to try and relax the use of one of the drugs and see? Then the other??? In my case I've wanted to explore that before I was resistant, but not so sure after the fact. Always coming to mind as well is maximum tolerable dose vs minimum effective dosages. Would changing the dose to minimal need for same effect then thereby extend it's length of time effectiveness? Untested waters there, have had this discussion with my MO, interesting discussion. Unfortunately we don't test blood levels of the drugs we consume, it isn't an individualized world of medicine out there, so there's that too.

Bottom line is, if there's a necessity, go for it! Nothing to lose by trying it, drugs can be stopped or changed. So there's that... Just do what you're doing, research it, educate yourself, have conversations with trained professionals like your MO about plusses vs minuses and make a decision!

Best Regards

[Nowhereman9]

thank you!!!